Drug User Liberation Front's Compassion Club and Fulfillment Center Model

"This case study underscores the feasibility of a community-based intervention in addressing the current public health crisis, revealing that drug users themselves can orchestrate a program aimed at safeguarding their communities. The DULF CC&FC serves as another compelling instance of drug users mobilizing to benefit their communities (Latkin & Friedman, 2012), operating several steps ahead of health bureaucracies (Kerr et al., 2001). In line with previous evaluations of drug user-run interventions, including studies on the activities of the Vancouver Area Network of Drug Users (Jozaghi & Yake, 2020), and unsanctioned and illegal overdose prevention sites in Vancouver (Kerr et al., 2004), Toronto (Foreman-Mackey et al., 2019), and the United Kingdom (Parkin & Coomber, 2009), our findings demonstrate positive outcomes associated with engagement by drug users with drug user run programming.

"While DULFʼs CC&FC shares similarities with other “compassion” or “buyers” clubs, such as those focused on providing access to medicinal cannabis (Kent, 1999) or antiretroviral therapy for HIV disease (Rhodes & Van De Pas, 2022), it represents a highly innovative form of safe supply programming. DULFʼs program also remains disjunct from other medical models as discussed in a recent evidence review insofar as it does not require a prescriber, daily dispensation, witnessed use, etc. (Ledlie et al., 2024). To this end, the distinction between a non-medicalized and medicalized supply of narcotics should not be drawn at its legality as suggested by Nielsen, Stowe, and Ritter when they state, “[in] contrast to the challenges of a nonmedical model, the medical models are legal” (Nielsen et al., 2024), and instead, the distinction should be focused on the imposition or lack of supervisory medical controls. Ultimately, there appears to be no evidence specific to interventions focused on ensuring access to a non-prescription safe supply of heroin, cocaine, and methamphetamine, aside from what has been generated by those involved in DULFʼs program itself. The lack of existing research on the impact of a safer drug supply that bypasses the medical system underscores the importance of contextualizing this work within the broader landscape of safer supply initiatives, their successes, and limitations (Penn et al., 2023). These initiatives have often faced challenges such as a lack of viable licit drug options (Karamouzian et al., 2023), severely limited capacity (Karamouzian et al., 2023), and ethical concerns among healthcare professionals (Cooper, 2023) (Lamb, 2021). With this said, an unpublished qualitative investigation revealed that the DULF CC was more culturally acceptable to participants than traditional prescriber based models (Bowles et al., n.d.)."